Effect of disclosure of HIV status on patient representation and adherence to clinic visits in eastern Uganda: A propensity-score matched analysis.

<h4>Background</h4>Disclosure of human immunodeficiency virus (HIV) status improves adherence to antiretroviral therapy (ART) and increases the chance of virological suppression and retention in care. However, information on the effect of disclosure of HIV status on adherence to clinic v...

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Autores principales:	Jonathan Izudi, Stephen Okoboi, Paul Lwevola, Damazo Kadengye, Francis Bajunirwe
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/a1b99fee8215409a999ec9a5190ca3db
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spelling	oai:doaj.org-article:a1b99fee8215409a999ec9a5190ca3db2021-12-02T20:16:46ZEffect of disclosure of HIV status on patient representation and adherence to clinic visits in eastern Uganda: A propensity-score matched analysis.1932-620310.1371/journal.pone.0258745https://doaj.org/article/a1b99fee8215409a999ec9a5190ca3db2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0258745https://doaj.org/toc/1932-6203<h4>Background</h4>Disclosure of human immunodeficiency virus (HIV) status improves adherence to antiretroviral therapy (ART) and increases the chance of virological suppression and retention in care. However, information on the effect of disclosure of HIV status on adherence to clinic visits and patient representation is limited. We evaluated the effects of disclosure of HIV status on adherence to clinic visits and patient representation among people living with HIV in eastern Uganda.<h4>Methods</h4>In this quasi-randomized study, we performed a propensity-score-matched analysis on observational data collected between October 2018 and September 2019 from a large ART clinic in eastern Uganda. We matched participants with disclosed HIV status to those with undisclosed HIV status based on similar propensity scores in a 1:1 ratio using the nearest neighbor caliper matching technique. The primary outcomes were patient representation (the tendency for patients to have other people pick-up their medications) and adherence to clinic visits. We fitted a logistic regression to estimate the effects of disclosure of HIV status, reported using the odds ratio (OR) and 95% confidence interval (CI).<h4>Results</h4>Of 957 participants, 500 were matched. In propensity-score matched analysis, disclosure of HIV status significantly impacts adherence to clinic visits (OR = 1.63; 95% CI, 1.13-2.36) and reduced patient representation (OR = O.49; 95% CI, 0.32-0.76). Sensitivity analysis showed robustness to unmeasured confounders (Gamma value = 2.2, p = 0.04).<h4>Conclusions</h4>Disclosure of HIV status is associated with increased adherence to clinic visits and lower representation to collect medicines at the clinic. Disclosure of HIV status should be encouraged to enhance continuity of care among people living with HIV.Jonathan IzudiStephen OkoboiPaul LwevolaDamazo KadengyeFrancis BajunirwePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 10, p e0258745 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jonathan Izudi Stephen Okoboi Paul Lwevola Damazo Kadengye Francis Bajunirwe Effect of disclosure of HIV status on patient representation and adherence to clinic visits in eastern Uganda: A propensity-score matched analysis.
description	<h4>Background</h4>Disclosure of human immunodeficiency virus (HIV) status improves adherence to antiretroviral therapy (ART) and increases the chance of virological suppression and retention in care. However, information on the effect of disclosure of HIV status on adherence to clinic visits and patient representation is limited. We evaluated the effects of disclosure of HIV status on adherence to clinic visits and patient representation among people living with HIV in eastern Uganda.<h4>Methods</h4>In this quasi-randomized study, we performed a propensity-score-matched analysis on observational data collected between October 2018 and September 2019 from a large ART clinic in eastern Uganda. We matched participants with disclosed HIV status to those with undisclosed HIV status based on similar propensity scores in a 1:1 ratio using the nearest neighbor caliper matching technique. The primary outcomes were patient representation (the tendency for patients to have other people pick-up their medications) and adherence to clinic visits. We fitted a logistic regression to estimate the effects of disclosure of HIV status, reported using the odds ratio (OR) and 95% confidence interval (CI).<h4>Results</h4>Of 957 participants, 500 were matched. In propensity-score matched analysis, disclosure of HIV status significantly impacts adherence to clinic visits (OR = 1.63; 95% CI, 1.13-2.36) and reduced patient representation (OR = O.49; 95% CI, 0.32-0.76). Sensitivity analysis showed robustness to unmeasured confounders (Gamma value = 2.2, p = 0.04).<h4>Conclusions</h4>Disclosure of HIV status is associated with increased adherence to clinic visits and lower representation to collect medicines at the clinic. Disclosure of HIV status should be encouraged to enhance continuity of care among people living with HIV.
format	article
author	Jonathan Izudi Stephen Okoboi Paul Lwevola Damazo Kadengye Francis Bajunirwe
author_facet	Jonathan Izudi Stephen Okoboi Paul Lwevola Damazo Kadengye Francis Bajunirwe
author_sort	Jonathan Izudi
title	Effect of disclosure of HIV status on patient representation and adherence to clinic visits in eastern Uganda: A propensity-score matched analysis.
title_short	Effect of disclosure of HIV status on patient representation and adherence to clinic visits in eastern Uganda: A propensity-score matched analysis.
title_full	Effect of disclosure of HIV status on patient representation and adherence to clinic visits in eastern Uganda: A propensity-score matched analysis.
title_fullStr	Effect of disclosure of HIV status on patient representation and adherence to clinic visits in eastern Uganda: A propensity-score matched analysis.
title_full_unstemmed	Effect of disclosure of HIV status on patient representation and adherence to clinic visits in eastern Uganda: A propensity-score matched analysis.
title_sort	effect of disclosure of hiv status on patient representation and adherence to clinic visits in eastern uganda: a propensity-score matched analysis.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/a1b99fee8215409a999ec9a5190ca3db
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Effect of disclosure of HIV status on patient representation and adherence to clinic visits in eastern Uganda: A propensity-score matched analysis.

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